In mechanically ventilated patients gastroesophageal reflux (GER) is a common problem, which contributes to the development of esophageal mucosal injury and even erosive esophagitis.
The relationship between percutaneous endoscopic gastrostomy (PEG) and subsequent development of GER is complex and not well understood.
Reflux Esophagitis- Overview
Reflux esophagitis is a condition causing inflammation of the lining of the esophagus. This happens when there is a upward movement of the acid from the stomach due to weakness of the esophageal sphincter.
Reflux esophagitis is a condition causing inflammation of the lining of the esophagus. This happens when there is a upward movement of the acid from the stomach due to weakness of the esophageal sphincter.
A cohort of 29 consecutive mechanically ventilated patients undergoing PEG was prospectively evaluated. The patients were divided into 2 groups based on whether GER decreased to less than 4% (responders, RESP group) or remained unchanged or worsened (non-responders, N-RESP group) after PEG placement. Reflux esophagitis and the gastroesophageal flap valve (GEFV) grading differed significantly between the two groups.
The researchers drew a conclusion that gastroesophageal reflux is not a contraindication for PEG tube placement. By identifying the factors that predict failure of PEG to decrease GER, their study may represent a reference in deciding which patients are likely to benefit from PEG tube placement and thus protect them from the development of esophagitis and even ventilator-associated pneumonia.
Gastroesophageal Reflux Disease (GERD)
This condition occurs due to the reflux of hydrochloric acid of the stomach into the oesophagus
This condition occurs due to the reflux of hydrochloric acid of the stomach into the oesophagus
Correspondence to: Emmanuel E Douzinas, MD, 3rd Department of Critical Care, Evgenidion Hospital, 20 Papadia¬mantopoulou St., Athens 115 28, Greece. [email protected]
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UT Southwestern Medical Center researchers have found in an animal study that GERD might not develop as a direct result of acidic digestive juices burning the esophagus.
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